Ch. 2 CMAA II: Question Preview (ID: 22957)

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Provider networks are patients, health care facilities, and doctor's offices who have contracts with health insurance companies to provide services.
a) True b) False c) d)
Precertification is the process of obtaining approval from a health insurance company for an admission, a test, procedure, or medication, also called preauthorization.
a) True b) False c) d)
Private Health Information (PHI) is any information concerning a patient's health, medical condition, diagnosis, or treatment; it can include financial information as well.
a) False b) True c) False and True d) None
Premiums are the costs for health insurance.
a) True b) False c) False and True d)
_____________ is the amount of money the patient must pay for medical care.
a) Deductible b) Out of Pocket c) Premium d) Copay
Medicaid is government provided health insurance for the poor and some disabled people.
a) True b) False c) True and False d)
________________ is government health insurance for older adults, retired individuals, and some people who are disabled.
a) Medicaid b) Medisoft c) Medicare d) Medialinsurance
_______________ is the amount of money that is the patient's share of the costs of treatment
a) Premium b) Out of Pocket c) Deductible d) Copay
Current Procedural Tests (CPT) codes are standard codes used to designate procedures and tests.
a) True b) False c) True and False d)
A contract is a legally binding agreement between two parties.
a) True b) False c) True and False d)
A(n) __________ is a small fee paid to a provider at the time services are rendered.
a) Deductible b) Premium c) Coinsurance d) Copay
A form submitted to a third party payer for reimbursement is called a(n) ____________.
a) Contract b) Claim c) Copayment d) CMS-1500
Customary is a term used to describe a _____________ fee which denotes the fee is usual and acceptable.
a) Provider's b) Doctor's c) Physician's d) All of the above
CMS-1500 is an unusual health insurance claim form.
a) True b) False c) d)
If someone is you're guarantor, you don't need to pay your healthcare costs.
a) True b) False c) d)
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